恶性淋巴瘤累及腹部淋巴结的CT增强表现及其解剖分布

CTfeaturesandanatomicdistributionofmalignantlymphomainabdominallymphnodes

目的：明确恶性淋巴瘤累及腹部淋巴结的ＣＴ增强表现特点及解剖分布，以提高定性、定位诊断的准确性。材料和方法：对４１例恶性淋巴瘤，包括Ｈｏｄｇｋｉｎ病（ＨＤ）１５例及非Ｈｏｄｇｋｉｎ淋巴瘤（ＮＨＬ）２６例，采用ＣＴ增强扫描，观察淋巴结的大小、形态、密度及解剖分布。结果：增大淋巴结的ＣＴ增强密度，ＨＤ中，８６．７％为均匀密度，１３．３％为均匀与不均匀密度并存；ＮＨＬ中，７３．１％为均匀密度，２６．９％为均匀与不均匀密度并存。ＨＤ及ＮＨＬ均优势累及腹主动脉周围、肾旁前间隙及肝十二指肠、肝胃韧带淋巴结。常同时使２个部位以上的淋巴结受累。结论：ＣＴ增强扫描可一定程度地显示恶性淋巴瘤的大体病理特点，存在２种强化类型，恶性淋巴瘤累及腹腔。

Purpose:ToclarifyenhancedCTfeaturesandanatomicdistributionofmalignantlym-phoma(ML)inabdominallymphnodesandimprovetheaccuracyofimagingdiagnosis.Materialsandmethods:Themorphology,densityanddistributionofthetumorfociwerestudiedin41patientswithdocumentedML,including15casesofHodgkindisease(HD)and26casesofnonHodgkinlym-phomabytheenhancedCT.Results:TheenlargedlymphnodesofHDandNHLpresentedhomoge-neous(HD86.7%,NHL73.1%)andhomogeneouswithinhomogeneous(HD13.3%,NHL26.9%)densityrespectively.AnatomicdistributionofHDissimilartothatofNHLwhichpromi-nentlyinvolvestheregionsofparaorta,anteriorpararenalspace,hepatoduodenalligamentandhep-atogastricligament.BothHDandNHLofteninvolvetwositesoflymphnodesandmore.Conclu-sion:ContrastenhancedCTimagingcanrepresentthegrosspathologicfeaturestocertainextent.MLlymphadenopathyinperitonealandretroperitonealspacehaspreferentialanatomicdistribution.